Japan plays down fears of ‘flesh eating’ disease

Global media has reported uptick in number of bacterial infections in country

Health authorities in Japan are attempting to play down reports in foreign media of a sharp uptick in the number of “flesh eating” streptococcal toxic-shock syndrome (STSS) cases, although a leading doctor of infectious diseases has admitted it was unclear how widespread the illness was or why it seemed to be spreading so swiftly.

Global media coverage of the outbreak has highlighted a spike in the number of cases of the rare but frequently deadly bacterial infection, highlighting an apparent fatality rate of 30 per cent.

A health ministry official stressed that travellers concerned about contracting STSS need not cancel their plans to visit Japan, telling the Asahi newspaper the frequent washing of hands, use of a face mask and keeping any open wounds clean should be sufficient to prevent infection.

Media coverage of the outbreak intensified when North Korea cancelled plans for the Japanese national football team to travel to Pyongyang last month for a qualifying match for the 2026 World Cup, with North Korean football authorities citing concern the foreign players would bring “the contagious disease spreading in Japan” into the country.

Japan’s health ministry pointed out the World Health Organization had not moved to limit travel to Europe in 2022 during a similar rise in STSS cases in the region.

From the start of the year to March 10, Japan’s National Institute of Infectious Diseases (NIID) recorded 474 STSS cases, compared with 941 in the whole of 2023. The infection had spread across the nation, with cases reported in 45 of Japan’s 47 prefectures, NIID said. “There are still many unknown factors regarding the mechanisms behind fulminant [severe and sudden] forms of streptococcus, and we are not at the stage where we can explain them,” the institute said.

A risk assessment issued by the NIID on March 29 identified STSS’ symptoms as including liver failure, renal failure, acute respiratory distress syndrome, soft-tissue inflammation, rashes and effects on the central nervous system.

It said an examination of the bacteria showed it was a variant of the M1UK strain, which was prevalent in Britain in the 2010s and was “considered to be highly pathogenic and transmissible”.

“It is becoming a serious problem, but there are still many things we do not know,” said Kazuhiro Tateda, president of the Japan Association of Infectious Diseases.

“We know that it is a variant of the strain that was spreading in the UK, but we do not know how or when it came to Japan,” he told This Week in Asia. Health experts understood STSS typically spread in the same way as other bacteria, primarily through skin contact, but treatment was proving challenging, Tateda admitted.